Ever have a blood bag explode?

[ShayRN]

I picked up on my old unit the other night and was transfusing a unit of blood. Special order, btw:imbar Halfway through the transfusion the pump starts alarming "air in line." So I try clamping the blood and flushing line with nss. Didn't help, pump alarmed again. I saw tiny, itty-bitty air bubbles in the tubing so I give the bag a little squeeze to get them through the area that senses for air bubbles....It was like a mass murder in the room. The bag started leaking out of the area where the donor's blood goes into the bag. There was blood on the curtain, blood on my shoes, blood all over the walls and floors. Man, it was bad. I have squeezed those darn bags many times over the last 10 years, never had that happen. Any similar experiences?

[DutchgirlRN, ASN, RN]

i was in a room with another rn, we were checking the bag of blood against the patients armband. when she spiked the blood i was standing right there next to her. suddenly blood started pouring all over the both of us, the pump, the floor...what a mess. once we had a chance to examine the bag it appeared to have split at the seams close to the port. we red-bagged it and took it to the lab. never heard anything else about it.

[RNDreamer]

I was wondering the same thing.

now here's another question, assuming that the blood has already been tested and all that... would you have to go to the ER and file an incident report and follow up for possible HEP/HIV exposure?

[Otessa, BSN, RN]

:chair:I haven't had that happen in my 16 years as a nurse.

WOW!!!

[miko014]

I was wondering the same thing.

Yes. At least at my facility you do. It may have been tested, but it's still someone else's blood. Counts as a body fluid exposure and you go to ER. Ever read the teaching info from the Red Cross? It says something along the lines of all blood is tested for HIV, West Nile, and (I think) Hepatitis, but there is still a very, very small chance that you could get something (not necessarily HIV or Hep, but something) from the transfusion. Gives the odds at like 1 in a million, but still possible. And if you didn't report it by following policy (going to ER or whatever your policy is), workmans comp wouldn't cover it if something did happen. Better safe than sorry!

From the Red Cross: "Although blood and blood products never can be 100% safe, the risk is very small. As of 1998, infection with HIV (the virus that causes AIDS) occurs less than once per 500,000 (half a million) units of blood transfused. Hepatitis C infection occurs about once per 100,000 units, and Hepatitis B occurs about once every 60,000 units. Other infections are transmitted much less often." http://chapters.redcross.org/ca/norcal/donor/guide.html

Sidenote - all I can think of is walking out of a room coverd in blood. I would just smile at the other patients who saw me and say "That guy used his call button too much."

[preemieRNkate, RN]

Oh man, what a mess! Glad I work in NICU, where we use small amounts of blood for our transfusions!

[beachmom]

When I was a student, a nurse asked a tech to get a unit of blood from the lab. The tech tossed it on the desk, and it splatted all over the desk, some charts and a few drops on one nurse. They made that nurse go through the whole work up for blood exposure.

I thought that was silly. They deemed the blood safe enough to put the whole unit in a pt's body, but a few drops on the nurse's cheek required a work up?

They did fill out an incident report.

What I thought was terrible about the incident was that after it happened, no nurse would clean up the mess. The housekeeper was on lunch, so they let the blood sit there on the desk about 20 minutes until she got back. I was a first year nursing student and didn't even know the proper way to clean it.

[miko014]

When I was a student, a nurse asked a tech to get a unit of blood from the lab. The tech tossed it on the desk, and it splatted all over the desk, some charts and a few drops on one nurse. They made that nurse go through the whole work up for blood exposure.

I thought that was silly. They deemed the blood safe enough to put the whole unit in a pt's body, but a few drops on the nurse's cheek required a work up?

They did fill out an incident report.

What I thought was terrible about the incident was that after it happened, no nurse would clean up the mess. The housekeeper was on lunch, so they let the blood sit there on the desk about 20 minutes until she got back. I was a first year nursing student and didn't even know the proper way to clean it.

Just because it was tested doesn't mean it's not infected. HIV can hide in the body for awhile before it can be detected in a blood test, and I'm sure other things can as well. Plus, they don't test for everything - you never know what could be in there. I'm not saying I'm against transfusions or anything like that. I work hem/onc, I give them all the time. I did one today, actually. But we are supposed to wear gloves to spike it and to disconnect and take it down after the transfusion (not that I always remember to do that). Plus, the pt consented to receive blood because they need it. The nurse didn't. Same principle as with chemo, really. Chemo has risks that pts are aware of, but if chemo gets on a nurse, that would be a bad thing, right??? I don't know if it's the same everywhere, but blood transfusion requires an informed consent, obtained by the doc, or else a doc signature that it is an emergency, or we can't do it. Seriously, it's better to be safe than sorry!!!!

And our housekeepers aren't allowed to clean up body fluids. We have to mop it up with towels and stuff first, then they clean the area. If there is a "residue", that's one thing, but if it's a puddle, they can't touch it.

[pagandeva2000, LPN]

This is some real Twilight Zone, Outer Limits or Freddy Cruger stuff! Never saw it happen, would have been horrified! Hope all is well.

[DeLana_RN, BSN, RN]

Because I've seen this happen when a coworker spiked a bag, I always wear a face shield when hanging blood (fortunately, these are readily available in dialysis).

DeLana

[ERbunny]

I saw this happen once, back in 1974, before HIV, thank goodness. We had a new nurse in our post -open heart unit, and the doctor was telling her to keep pumping the blood in. (post mitral valve, a little rocky), and all of a sudden --kaPOW !!! I thought the doctor was gonna bust a gut, he laughed harder than the rest of us... her face went ashen...and what a mess...Reminded me of the time someone forgot a tomato soup can in a warming drawer we had :that was a very impressive explosion at 3 am.....also a big mess.....

[EricJRN, MSN, RN]

I know of one situation where a bag of granulocytes (a seldom-used, difficult-to-collect blood product) exploded after being placed in a vacuum tube system against hospital policy.